• Portsmouth Hospitals Trust rated “requires improvement” for caring
  • Safety concerns raised over trust’s emergency department 
  • But Care Quality Commission says there are “signs of change” 

A chief executive says he is “disappointed” with his trust being rated among the worst in England for staff being “caring” towards patients, but believes improvements to “long standing challenges” are being made overall.

The Care Quality Commission has again rated Portsmouth Hospitals Trust as “requires improvement”, but said there have been positive signs of change since its previous inspection.

However, it became only one of five trusts in England to be rated “requires improvement” or worse in the caring domain, according to the CQC.

Inspectors said staff in the emergency department were not always “compassionate or respectful”. Examples included a nurse who was “shouting at an agitated patient”, and the failure of nearby staff to look after a frail and confused elderly patient in need of help.

In total, two of the nine services inspected (urgent and emergency, and medical services) were rated “requires improvement” for caring.

Among the CQC’s other findings included:

  • The design and layout of the emergency department did “not keep people safe”, and waiting times were poor;
  • “Inadequate” senior medical cover at night, which was provided by a registrar or middle grade doctor with a consultant on call;
  • Concerns about the safety culture in theatres.

But there were also several areas of outstanding practice, such as the performance of the critical care team and the provision of mental health support in the emergency department.

Mr Cubbon, who has been the trust’s chief executive for just over a year, told HSJ he is “disappointed” with the caring rating, but said the physical constraints of the emergency department meant staff were working in “challenging conditions”.

He added: “No one comes to work with the intention of providing bad care (but) we need to make sure we can get the conditions right to improve our teams.”

He said the trust, together with the Hampshire and Isle of Wight Sustainability and Transformation Partnership, has submitted a capital bid for funding to expand the emergency department.

Mr Cubbon added that the report overall showed the trust was making progress in addressing “long standing challenges”.

The trust was rated “good” for diagnostic imaging – nine months after the CQC found patients had died after failings in the radiology department.

A spokeswoman for NHS Improvement said it was “encouraging inspectors had found areas of improvement”, and added they had faith in the trust’s leadership team’s ability to address the challenges.